Provider Demographics
NPI:1275068587
Name:COMER, ANSLEY STEWART (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ANSLEY
Middle Name:STEWART
Last Name:COMER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ANSLEY
Other - Middle Name:GAIL
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:222 W CLINTON ST # 3
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:GA
Mailing Address - Zip Code:31032-5457
Mailing Address - Country:US
Mailing Address - Phone:478-986-5400
Mailing Address - Fax:
Practice Address - Street 1:222 W CLINTON ST # 3
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:GA
Practice Address - Zip Code:31032-5457
Practice Address - Country:US
Practice Address - Phone:478-986-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-24
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT012838225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist